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General NPI Number Information
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NPI Number | 1316156391
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Entity Type | Individual
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Provider Name | OLANIRETI ONABANJO NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 9650 SANTIAGO RD STE 109
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City | COLUMBIA
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State | MD
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Zip | 21045-3958
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Country | US
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Telephone | 240-732-1009
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Fax | 240-755-0102
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Provider Business Mailing Address
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Address Line | 9650 SANTIAGO RD STE 109
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City | COLUMBIA
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State | MD
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Zip | 21045-3958
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Country | US
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Telephone | 240-732-1009
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Fax | 240-755-0102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R208320
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024179218
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R208320
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | R208320
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License Number State | MD
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